Understand what to expect when entering menopause

After years of regular menstruation, the onset of perimenopause and the transition to full menopause can be both physically and emotionally uncomfortable. The impact of this transition — the severity of its side effects and one’s tolerance for such symptoms — may vary widely from woman to the next. Ease the progression through this natural phase of life by communicating openly with your doctor and gaining a better understanding of what to expect.

“The transition to menopause is known as perimenopause, typically beginning four years prior to the final menstrual period,” said Jenine Paner, DO, a family medicine physician at Renown Medical Group. “Symptoms include irregular periods, hot flashes, sleep changes, mood changes and vaginal dryness. All women have some symptoms, but the severity of symptoms differs.”

According to Paner, the average age of perimenopause is 47 years, and the average age of menopause is around 51 years, ranging from approximately 45 to 55. Genetics and lifestyle factors, such as weight and tobacco use, can affect the age of menopause, she said.

As for the differences between perimenopause and menopause, the symptoms women experience during these back-to-back phases can be quite similar, except for the fact menstruation stops completely when a woman enters menopause.

“Symptoms of menopause are really the same as perimenopause, except that there is a cessation of menstruation instead of irregular menstruation,” said Dani Barisone, an advanced practice registered nurse with Northern Nevada Medical Group. “Perimenopause does not guarantee infertility.”

Deciding whether to seek treatment for the side effects of perimenopause and menopause is a personal choice and tends to depend on how much these symptoms are affecting your quality of life. Even if you decide not to receive medical care for menopause, talking to your doctor about the ways in which your body is changing is a smart move for best health.

“If a woman is experiencing typical symptoms of menopause and is over 45, no hormonal workup is typically needed,” Paner said. “However, it is important to talk to your doctor about all symptoms to assure no other causes of symptoms are involved.”

Among the most common and bothersome side effects of perimenopause and menopause are mood changes, vaginal dryness and hot flashes, the latter of which may occur more frequently during periods in perimenopause, Paner said.

“Hot flashes are a sudden sensation of heat that usually starts in the upper chest or face and may progress to cover the whole body for two to four minutes,” she said. “Women also may have sweating and heart palpitations, followed by chills, shivering or anxiety. These episodes may occur several times a day, [and] hot flashes typically last for more than a year without treatment.”

As far as treatment options to help alleviate hot flashes and other issues associated with perimenopause and menopause, these can range from dressing in layers and using an over-the-counter vaginal lubricant to receiving hormone replacement therapy or taking an antidepressant.

“There is a variability of symptoms, as well as tolerance for symptoms, that is individual from one woman to another,” Barisone said. “The discussion of symptoms and possible treatment options should be brought up at an annual exam with your gynecologist or primary care provider.”